diabetestalk.net

Diabetesa1c

Pregnancy With Type 1 Diabetes: A1c Strategies That Work For Me

Pregnancy With Type 1 Diabetes: A1c Strategies That Work For Me

Pregnancy with Type 1 Diabetes: A1C Strategies that Work For Me Im officially 20 weeks pregnant! Yahoo, half-way there (and if youre a diabetic then you know they wont let you go past 38 weeks, so Im technicallymorethan half-way there)! Im so relieved to share that my latest A1C came back at 5.7 percent. While that is exactly what Im aiming for and hoping for, it also feels like a slight miracle during this 2nd pregnancy when most of my day is about chasing after a toddler and trying to work part-time during each free moment I get! Theres little time left for obsessing about blood sugar levels and taking extra tiny little doses of correction insulin, let alone eating! (For example: today, I ate lunch at 4 p.m. because of dentist appointment + picking up toddler at friends house + walking dog + gettingtoddler down for nap + getting on the phone for an hour-long work meeting + toddler woke up from nap way too early = mama is just catching her breath.) Heres an A1C translation chart so you can see what your A1C means in terms of blood sugar levels. During my 1st pregnancy, my A1C goals were as low as possible because I had all the energy in the world to devote to blood sugar management (exercising daily, eating healthy foods, planning all meals ahead so I can pre-bolus exactly the right amount of time for that mealyada yada yada.) It led to A1Cs as low as 5.1 percent the first time around something Ive expressed in previous blogs I am not even interested in achieving as a pregnant gal with a toddler! But I still have goals: like keeping my A1C between 5.7 and 6.1 percent. Here are a few simple things that help meachieve my A1C goals: 1.Somelow-carb meals: Eatingsomemeals that are low-carb so the work involved in maintaining tight, in-range blood sugar levelsafterthat meal Continue reading >>

Diabetes: A1c Test | Peacehealth

Diabetes: A1c Test | Peacehealth

Medical Review: Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Matthew I. Kim, MD - Endocrinology, Diabetes and Metabolism & David C. W. Lau, MD, PhD, FRCPC - Endocrinology PeaceHealth endeavors to provide comprehensive health care information, however some topics in this database describe services and procedures not offered by our providers or within our facilities because they do not comply with, nor are they condoned by, the ethics policies of our organization. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy . Learn How this information was developed . To learn more about Healthwise, visit Healthwise.org . 2011-2018 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Continue reading >>

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

Do I Have Prediabetes Or Diabetes? Guide To The A1c, Fpg, And Ogtt Tests, Plus Tips For Prevention

If you’ve been diagnosed with prediabetes, you may wonder what that means. It’s a condition where your blood glucose levels are above normal, but not high enough for you to be diagnosed with diabetes. Many doctors consider prediabetes to be the first stage of type 2 diabetes. Studies show that 15 to 30 percent of people with prediabetes will develop diabetes in as little as five years without intervention, such as weight loss or increased physical activity. In fact, most people who get type 2 diabetes had prediabetes first. Prediabetes is serious in and of itself. People with this condition have a greater risk of developing cardiovascular disease than those without it. There are three tests that doctors can do in order to determine whether you have high blood sugar. A1C This blood test, which is also called hemoglobin A1c, HbA1c, or glycosylated hemoglobin, measures the percentage of sugar that is attached to your hemoglobin. Hemoglobin is a protein in your red blood cells. The higher the A1C, the higher your average blood sugar levels have been running over the past two or three months. A normal A1C is below 5.7 percent. An A1C between 5.7 percent and 6.4 percent suggests prediabetes. An A1C of 6.5 or more indicates type 2 diabetes if the test is confirmed. If your results are questionable, your doctor will retest your A1C on another day to confirm the diagnosis. Fasting plasma glucose The fasting plasma glucose (FPG) test is a blood test that’s done after you’ve been fasting overnight. It measures the sugar in your blood. A normal fasting glucose test is lower than 100 milligrams per deciliter (mg/dL). A result between 100 and 125 mg/dL is diagnostic for prediabetes. One that is 126 mg/dL or above is indicative of diabetes. It’s recommended to retest this an Continue reading >>

The A1c Test & Diabetes

The A1c Test & Diabetes

What is the A1C test? The A1C test is a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months. The A1C test is sometimes called the hemoglobin A1c, HbA1c, or glycohemoglobin test. The A1C test is the primary test used for diabetes management and diabetes research. How does the A1C test work? The A1C test is based on the attachment of glucose to hemoglobin, the protein in red blood cells that carries oxygen. In the body, red blood cells are constantly forming and dying, but typically they live for about 3 months. Thus, the A1C test reflects the average of a person’s blood glucose levels over the past 3 months. The A1C test result is reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent. Can the A1C test be used to diagnose type 2 diabetes and prediabetes? Yes. In 2009, an international expert committee recommended the A1C test as one of the tests available to help diagnose type 2 diabetes and prediabetes.1 Previously, only the traditional blood glucose tests were used to diagnose diabetes and prediabetes. Because the A1C test does not require fasting and blood can be drawn for the test at any time of day, experts are hoping its convenience will allow more people to get tested—thus, decreasing the number of people with undiagnosed diabetes. However, some medical organizations continue to recommend using blood glucose tests for diagnosis. Why should a person be tested for diabetes? Testing is especially important because early in the disease diabetes has no symptoms. Although no test is perfect, the A1C and blood glucose tests are the best tools available to diagnose diabetes—a serious and li Continue reading >>

Diabetes: A1c Test (video)

Diabetes: A1c Test (video)

Medical Review: Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Matthew I. Kim, MD - Endocrinology, Diabetes and Metabolism & David C. W. Lau, MD, PhD, FRCPC - Endocrinology This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy . Learn How this information was developed . To learn more about Healthwise, visit Healthwise.org . 2011-2018 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences | Supplemental content provided by Healthwise, Incorporated. To learn more, visit www.healthwise.org For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1. UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations. Medical information made available on UPMC.com is not intended to be used as a su Continue reading >>

Diabetes A1c Champions Program To Be Held At Baystate Mary Lane Hospital

Diabetes A1c Champions Program To Be Held At Baystate Mary Lane Hospital

Diabetes A1C Champions Program to Be Held at Baystate Mary Lane Hospital WARE Alicia Walter, clinical dietitian and nutrition educator at Baystate Mary Lane Hospital, will present the Hemoglobin A1C Champion Program on Sept. 7 from 5 to 6 p.m. The program will be held in the main conference room of the hospital located on the second floor. The Diabetes A1C Champions Program, sponsored by Sanofi-Aventis U.S., is a patient-led approach to diabetes education. The program will include an empowering presentation for people with diabetes, their families, and friends. This patient-to-patient presentation will include information about the physical, emotional, and psychological experience of living with diabetes. According to Walter, a diabetic diet should not be a rigid and restrictive menu plan. There is not one ultimate diabetic diet that everyone should follow; instead, nutritional management of diabetes is a lifestyle that balances moderation and healthy food choices. The AIC Champion program is designed to empower others to make the right choices in taking care of their diabetes. In addition, the Baystate Mary Lane Hospital Diabetes Support Group, facilitated by Walter, meets the first Wednesday of every month from 5 to 6 p.m. in the main conference room located on the second floor of the hospital. Meetings are open to community members who have diabetes, their families, and anyone who is interested in learning more about diabetes. There is no cost to attend, and examples of diabetic-friendly refreshments will be served. For more information or to register, contact Baystate Health Link at (413) 967-2488 or (800) 377-4325. Any unauthorized duplication of this site is strictly prohibited and liable to prosecution. Continue reading >>

In Search Of: The Highest Diabetes A1c In History

In Search Of: The Highest Diabetes A1c In History

My most recent A1C was nothing to be proud of, but I consoled myself with the thought that it was hardly the worst in history. That got me wondering: What was the all-time worst A1C? Who holds this dubious record, and how high is it possible to go? I decided to pound the pavement and try to find out. So where to start when looking for a diabetes record? Well, with the Guinness Book of World Records, of course. But oddly, the Guinness people don’t seem to have any listings related to A1Cs. They do, however, report that Michael Patrick Buonocore survived a blood sugar of 2,656 mg/dL upon admittance to the ER in East Stroudsburg, PA, on March 23, 2008. Michael was a T1 kiddo at the time, and that record-high sugar level was part of his diagnosis experience. So does Michael also hold the record for top A1C? No. Because while he’s living (thankfully) proof that stratospheric blood sugar levels are possible, a sky-scraping A1C requires both altitude and time. Remember that A1Cs provide a three-month average of our blood sugars. Individual high BG readings, even crazy-high ones, don’t alter the test as much as you’d think if they last only a short time. Because type 1 in kids Michael's age hit so quickly, I figured his A1C would have been rather middle of the road. It takes a slow burn to make an A1C boil. But just to be sure, I reached out to his parents, who tell me his A1C was 11.9 at diagnosis. Higher than I expected, but not too high given the four-digit BG reading. (If his 2,656 had been his average blood sugar for three months, his A1C would have been roughly 95! Yes, that’s 95.0, not 9.5). The highest A1C turns out to be a tricky piece of data to ferret out. If you try Google, you find a gazillion people talking about their own personal highest A1Cs, and comp Continue reading >>

#96: Diabetes: A1c Targets & Acp Guidelines Controversy

#96: Diabetes: A1c Targets & Acp Guidelines Controversy

#96: Diabetes: A1C targets & ACP guidelines controversy Get schooled on hemoglobin a1c targets in type 2 diabetes by American College of Physicians guidelines coauthor, Devan Kansagara MD MCR, Associate Professor of Medicine, Oregon Health Sciences University. We summarize outcomes from the landmark diabetes trials (ACCORD, ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effect microvascular and macrovascular events, estimating life expectancy, and how to personalize diabetes control for your patients. Were proud to announce our new partnership with the ACP to provide free CME credit and MOC points on select episodes of The Curbsiders. ACP members can visit acponline.org to redeem free CME/MOC credit. Join our mailing list to receive a PDF copy of our show notes every Monday. Rate us on iTunes , recommend a guest or topic and give feedback at [email protected] Written, produced, and edited by: Matthew Watto MD. Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD. Microvascular complications such as albuminuria ( ADVANCE ), need for retinal photocoagulation ( UKPDS 33 ) can be prevented with long term control of DM2, though the clinical significance of these outcomes is controversial ( Circ Cardiovasc Qual Outcomes 2016 ) Early initiation of metformin after diagnosis of DM2 reduces MI, and all cause mortality at median 10.7 years ( UKPDS 34 ) and persists at 20 years when compared to diet alone. Intensive therapy (for up to 11 years) with insulin, sulfonylureas and other early generation hypoglycemic agents does not prevent macrovascular complications of death, CV death, nonfatal stroke (VADT, ACCORD, ADVANCE, UKPDS 33), but seems to confer a small 15% relative risk reduction for nonfatal MI ( Circ Cardiovasc Qual Outcomes 2016 ). The ACCORD trial found a Continue reading >>

Diabetes: A1c Targets & Acp Guidelines Controversy

Diabetes: A1c Targets & Acp Guidelines Controversy

Home CME & MOC Online Learning Center Diabetes: A1C targets & ACP guidelines controversy Diabetes: A1C targets & ACP guidelines controversy STEP 2 (Members Only): Take the CME/MOC Quiz Matthew Watto, MD Presenter, Planner, Quiz Writer Those named above unless otherwise indicated have no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients. *Cynthia Smith, MD, FACP disclosed spouse employment with Merck and Co. and stock options/holdings with Merck and Co. This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American College of Physicians and the Curbsiders. The American College of Physicians is accredited by the ACCME to provide continuing medical education for physicians. The American College of Physicians designates each enduring material (podcast) for 1 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity. ABIM Maintenance of Certification (MOC) Points Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 medical knowledge MOC Point in the American Board of Internal Medicines (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity providers responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. After listening to the podcast, complete a brief multiple-choice question quiz. To Continue reading >>

Could New Diabetes A1c Guidelines Do More Harm Than Good?

Could New Diabetes A1c Guidelines Do More Harm Than Good?

Could New Diabetes A1C Guidelines Do More Harm Than Good? Written by Mike Hoskins on March 13, 2018 The American College of Physicians (ACP) has published new care guidelines suggesting higher blood sugar targets for people with type 2 diabetes. But many fear they may be doing harm than good with this change, that could potentially lead to patients developing more long-term complications and PWDs (people with diabetes) facing increased barriers to accessing to the supplies and medications we need. Not good. Published March 6 in the Annals of Internal Medicine , these new guidelines call for A1C targets of 7-8% for most T2 PWDs, noting that lower A1C goals of 6.5% to 7% as recommended by the big diabetes orgs are too strict. While the new guidelines do recommend "personalization of glycemic goals" depending on patients' individual circumstances, they clearly call for "deintensifying" therapy across the board. The ACP cites studies showing evidence that encouraging T2s to check blood sugar more often and take more medications has not been beneficial. "The evidence shows that for most people with type 2 diabetes, achieving an A1C between 7-8% will best balance long-term benefits with harms such as low blood sugar, medication burden, and costs, ACP President Dr. Jack Ende said in a press release . Not everyone agrees. In fact, this is causing a firestorm among the diabetes authorities, who worry that these new guidelines, while specific to T2, could have negative implications for all PWDs: downgrading care and providing a basis for insurers to further restrict access to testing supplies, needed medicines and of course CGMs (continuous glucose monitors). The ACP guidelines are aimed at primary care physicians, who remain the main source of care for millions of T2Ds in this Continue reading >>

Your A1c Levels – What Goal To Shoot For?

Your A1c Levels – What Goal To Shoot For?

Measuring Your A1C An A1C test gives you and your provider insight into all of your blood glucose ups and downs over the past two or three months. It’s like the 24/7 video of your blood sugar levels. Observing your A1C results and your blood glucose (also known as blood sugar) results together over time are two of the key tools you and your health care provider can use to monitor your progress and revise your therapy as needed over the years. Recent research is changing the way health professionals look at A1C levels. Instead of setting tight controls across the board, a healthy A1C level is now a moving target that depends on the patient. In the past, an A1C of 7 percent was considered a healthy goal for everyone. Yehuda Handelsman, M.D., medical director of the Metabolic Institute of America in Tarzana, California, says experts now recommend taking a patient-centered approach to managing A1C levels, which means evaluating goals based on individual diabetes management needs and personal and lifestyle preferences. Current ADA Goals The 2015 American Diabetes Association (ADA) Standards of Medical Care in Diabetes advise the following A1C levels: • 6.5 percent or less: This is a more stringent goal. Health care providers might suggest this for people who can achieve this goal without experiencing a lot of hypoglycemia episodes or other negative effects of having lower blood glucose levels. This may be people who have not had diabetes for many years (short duration); people with type 2 diabetes using lifestyle changes and/or a glucose-lowering medication that doesn’t cause hypoglycemia; younger adults with many years to live healthfully; and people with no significant heart and blood vessel disease. • 7 percent: This is a reasonable A1C goal for many adults with d Continue reading >>

The Abcs Of Diabetes: A1c, Blood Pressure, And Cholesterol

The Abcs Of Diabetes: A1c, Blood Pressure, And Cholesterol

Three important diabetes measures There is so much to think about when you have diabetes, but this easy-to-remember acronym will help you focus on what’s important and take control of your health. Read our breakdown and talk to your doctor about what’s right for you. A = AIC What is it? An A1C blood test measures the percentage of hemoglobin (the oxygen-carrying protein in your red blood cells) coated with sugar. It measures your average blood glucose (sugar) level over the past two to three months. The A1C test gives you and your health care provider a measure of your progress. Most people with diabetes should have an A1C test every three to six months; people who are meeting their treatment goals may need the test only twice a year. Why is it important? The A1C test is a good measure of how well your glucose is under control. It can also be a good tool for determining if someone with prediabetes is progressing toward or has developed type 2 diabetes. Adults over age 45 with hypertension, obesity, or a family history of diabetes also are advised to get an A1C test because they have a greater risk of developing type 2 diabetes. Finding out you have an elevated A1C is a cue to make positive changes to your lifestyle. What do the numbers mean? 5.7% or lower = normal blood glucose levels 5.8–6.4% = elevated blood glucose levels (prediabetes) 6.5% or higher = diabetes What should my numbers be? For years, people with type 2 were told to strive for an A1C of 7 percent or less, but new research indicates that one level doesn’t fit all. Based on your health status, age, and risk factors, you and your health care provider should determine an A1C goal for you. Here are the American Diabetes Association’s new general guidelines: Person newly diagnosed with type 2 diabet Continue reading >>

The Curbsiders Internal Medicine Podcast | Meded | Foamed | Internist | Hospitalist | Primary Care | Family Medicine

The Curbsiders Internal Medicine Podcast | Meded | Foamed | Internist | Hospitalist | Primary Care | Family Medicine

#96: Diabetes: A1C targets & ACP guidelines controversy Get schooled on hemoglobin a1ctargets in type 2 diabetes mellitus by American College ofPhysicians guidelines coauthor, Devan Kansagara MD MCR, AssociateProfessor of Medicine, Oregon Health Sciences University. Wesummarize outcomes from the landmark diabetes trials (ACCORD,ADVANCE, VADT, UKPDS 33 & 34), how a1c targets effectmicrovascular and macrovascular events, estimating life expectancy,and how to personalize diabetes control for your patients. Wereproud to announce our new partnership with the ACP to provide freeCME credit and MOC points on select episodes of The Curbsiders. ACPmembers can visit acponline.org to redeem free CME/MOCcredit. Full show notes availableat Join our mailing list to receive a PDF copy of ourshow notes every Monday. Rate us on iTunes , recommend a guest or topic and give feedbackat [email protected] Written, produced, andedited by: Matthew Watto MD. Hosts: Stuart Brigham MD,Paul Williams MD, Matthew Watto MD. 03:11 Getting to know ourguest: one liner, book recommendation, mentorship 06:50 How and why did ACP writetheir guidance statement on diabetes, A1C targets 11:36 Does tight controlprevent micro or macrovascular complications 13:20 Trials of newer agentslike SGLT2i, GLP-1 and DPP4i 14:33 How do ACPs guidelinesdiffer from other published guidelines 17:20 Quick recap of landmarktrial findings 24:30 Controversy over an A1Cgoal of 7-8% 38:29 Life expectancy andcomorbid conditions 46:30 The Curbsiders recap andgive some closing remarks Tags: diabetes,a1c, target, dm, hypoglycemia, glycemic, intensive, tight, glucose,control, cardiovascular, risk, outcome, mortality, death,metformin, insulin, acp, guideline, accord, advance, vadt, ukpds,microvascular, macrovascular, aace, ada, VA, Continue reading >>

Setting Appropriate A1c Goals For Patients With Type 2 Diabetes

Setting Appropriate A1c Goals For Patients With Type 2 Diabetes

Condition Center Home > Clinical Essentials Setting Appropriate A1C Goals for Patients With Type 2 Diabetes Are the ADA's A1C target recommendations for type 2 diabetes patients too conservative? Or is the AACE/ACE Consensus Statement's approach too aggressive? Reviewed by Clifton Jackness, MD, Attending Physician in Endocrinology, Lenox Hill Hospital and the Mount Sinai Medical Center, New York, NY Assessment of glycemic control in patients with type 2 diabetes can be achieved through patient self-monitoring of blood glucose (SMBG) and A1C determinations.1,2 The American Diabetes Association (ADA) recommends regular A1C testing to evaluate the effectiveness of current management strategies, but the target A1C goal can vary depending on the individual patient profile as well as the set of professional consensus recommendationsand associated management philosophyto which the treating clinician adheres. According to the ADA, the generally accepted standard A1C goal for adult patients with type 2 diabetes is 7.0%.1,2 Driving A1C below this level has been shown to reduce microvascular complications. In addition, if achieved quickly after a diabetes diagnosis, this A1C goal has been associated with a long-term reduction in macrovascular disease as well.1,2 According to ADA guidelines, the standard A1C goal for adults with T2DM is 7.0%, but this can vary depending on individual patient profiles. The AACE/ACE recommendations are more aggressive, with a target A1C of ?6.5% to minimize risk of diabetes-related complications. Until large clinical trials utilizing newer therapies are done to evaluate the risks and benefits of intensive therapy, it is likely that the ADA and AACE/ACE recommendations will continue to differ. The ADA suggests that physicians may lower the A1C target Continue reading >>

Hacking Diabetes: A1c Testing

Hacking Diabetes: A1c Testing

0 What Is An A1C Test? A1C is a common blood test used to diagnose type 1 and type 2 diabetes and gauge how well a person is managing their diabetes. The A1C test result reflects a person’s average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of their hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar. The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. The American Diabetes Association recommends that all abnormally high blood sugar tests (taken while fasting) be followed up with more detailed testing for a definitive diagnosis. Historically, this test has been used to manage the long-term treatment of known diabetics and is used as an indicator of diabetic control. The A1C is also useful in identifying undiagnosed diabetics in the non-fasting environment commonly encountered at employee health fairs. What A1C Level Is Considered Normal? Hemoglobin A1C levels of 4.5% to 5.7% are considered normal. The A1C goal for people with diabetes is less than 7%. A change in a patient’s treatment plan is almost always needed if the test result is over 8%. If patients can lower their HbA1c numbers by any amount, they will improve their chances of staying healthy. How Often Should A Person Get Tested? People diagnosed as having diabetes should get the HbA1c test at least two times a year if their blood sugar is in the target range and stable. If they are taking insulin, if their treatment changes or if their blood sugar stays too high, they should get the HbA1c test at least every 3 months until their blood sugar level improves. If you have a history of diabetes in your family, it’s important that you get tested. Contac Continue reading >>

More in diabetes